Can metastatic lymph node ratio (LNR) predict survival in oral cavity cancer patients?

• Published in: Journal of surgical oncology 2013-09, Vol.108 (4), p.256-263
• Main Authors: Sayed, Suhail I., Sharma, Shilpi, Rane, Pawan, Vaishampayan, Sagar, Talole, Sanjay, Chaturvedi, Pankaj, Chaukar, Devendra, Deshmukh, Anuja, Agarwal, Jai Prakash, D'cruz, Anil K.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - pathology; Confidence intervals; Female; Follow-Up Studies; Humans; Lymph Node Excision; Lymph Nodes - pathology; Lymphatic Metastasis; Male; Medical research; metastatic lymph node ratio; Middle Aged; Mouth Neoplasms - mortality; Mouth Neoplasms - pathology; Multivariate analysis; neck metastasis; Neoplasm Recurrence, Local; Neoplasm Staging; oral cavity cancer; Proportional Hazards Models; Retrospective Studies
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.23387

Objectives To evaluate the prognostic role of the lymph node ratio (LNR; ratio of total positive nodes to total dissected nodes) in oral squamous cell carcinoma (OSCC) as compared to pN staging with an aim to provide an optimal cut‐off value. Methods 1,408 OSCC previously untreated patients who underwent treatment (surgery + neck dissection + adjuvant treatment). LNR sensitivity with respect to survival was calculated using receiver operating characteristic (ROC) curves and Cox regression method. LNR and TNM staging variables were subjected to multivariate analysis. Results LNR (0.088) showed significant association with survival outcomes. For patients with LNR ≤0.088, the OS, DFS, local control, regional control and distant metastasis rates were 64%, 70%, and 89%; for LNR >0.088 it was 22%, 19%, and 52%, respectively (P